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On The Cutting Edge

A team at Tufts has pioneered a new process to replace damaged ligaments -- which could transform the way doctors treat the 200,000 people who suffer annually from ACL injuries.

Medford/Somerville, Mass. [02.13.02] A former offensive tackle and pre-season All American for Tufts' football team, Greg Altman knows the devastating impact of an anterior cruciate ligament (ACL) injury first-hand. After tearing the ligament in his knee -- which ended his football career at Tufts -- Altman focused on finding a more effective way to treat ACL injuries while dramatically reducing the recovery time for the 200,000 people who have ligaments repaired every year.

"Using a narrow tube and some specially-designed silk, researchers said on Monday they had been able to grow ligaments that should one day offer a grow-your-own knee repair operation," reported Reuters. "They said their replacement anterior cruciate ligaments (ACL) could help many of the half-million or so people who tear them every year in the United States alone."

The announcement -- made by Altman and his colleagues during an orthopedics conference in Dallas -- received international attention, as media organizations from the Europe, the US, and Asia carried the news.

"The technology for this tissue repair and ligament growth could fundamentally change the way we treat this very common injury," Altman said in a USA Today report.

Altman, a doctoral candidate who already holds a degree from Tufts in chemistry, worked closely with an interdisciplinary team of Tufts experts -- including David Kaplan, the director of Tufts' Bioengineering Center and Dr. John Richmond, an orthopedics expert at Tufts' Medical School.

After several years of cutting edge research, the group developed a system to grow stem cells into fully-functional ligaments.

"Altman's team started with bone marrow stromal cells, which are ... similar to stem cells in that they can be reprogrammed to produce a variety of different cells," reported Reuters. "But the reprogramming is hard to do. Altman's team set up a mechanical system -- the bioreactor -- to imitate the stresses and strains a ligament undergoes to see if that would do the trick."

It worked -- producing tissue with the same properties as a ligament. The advancement could have a major impact on the way doctors repair ACL injuries.

"Now, surgeons remove the torn ACL and replace it with tendons taken from the hamstring of patella, weakening those areas," reported the Boston Herald. "The Tufts strategy would take a patient's own adult stem cells and use them to grow new ligament tissue."

That's promising news for both doctors and patients.

"Orthopedic surgeons and active people all over the world will find great hope in this research," said Tufts' Richmond, who is also the chief of adult orthopedics and sports medicine at Tufts-New England Medical Center. "We look forward to the day when we'll be able to replace a damaged ligament with a healthy new one, grown from our own tissue."

By providing new ligament tissue grown from the patient's stem cells, Altman's process could make the surgery safer, while speeding recovery times.

"Since the ACL has poor healing capabilities, our new ligament could significantly reduce the recovery time to just weeks -- rather than months -- for professional athletes and sports enthusiasts compared with current surgery practices," Altman said.

Pre-clinical trials are slated for this year, and Altman hopes the new ligaments will be in use in five to seven years.

Though it is expected to help millions, Altman won't be able to take advantage of his own research.

"Even if this works, there is nothing they can do for me," the Tufts doctoral student told Reuters, referring to his season ending ACL injury in 1996. "I am over the hill."

But the Tufts research is expected to help the 200,000 people who have ACL surgeries every year in the U.S. alone -- which cost $3.5 billion annually